关键词: 大环内酯类耐药肺炎支原体肺炎, “清宣通络”法, 疗效观察, 儿童

Abstract:

Objective To observe the clinical efficacy of the "Qingxuan Tongluo" method(clearing, diffusing, and unblocking collaterals) in the treatment of macrolide-resistant Mycoplasma pneumoniae pneumonia in children. Methods A total of 120 pediatric inpatients with macrolide-resistant Mycoplasma pneumoniae pneumonia, admitted to the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine from November 2024, were enrolled and randomly divided into an observation group and a control group, with 60 cases in each group. Macrolide antibiotics were used as the anti-infective therapy in both groups. All included cases were diagnosed with the pattern of wind?heat obstructing the lung. The control group received treatment based on the principle of "ventilating the lung, opening the blockage, relieving cough, and calming wheezing", using a modified Yinqiao powder combined with Maxing Shigan decoction. If the pattern shifted to phlegm?heat obstructing the lung, Wuhu decoction and Tingli Dazao Xiefei decoction were administered instead. The observation group was treated with the modified Qingxuan Tongluo formula, under the guidance of the "Qingxuan Tongluo" method. The treatment course lasted 14 days in both groups. Comparisons were made between the two groups regarding therapeutic efficacy, clinical recovery time, time to complete defervescence, time to relief of cough and sputum, traditional Chinese medicine(TCM) syndrome scores, disappearance rates of individual symptoms and signs, and safety evaluation. Results Three cases dropped out from the observation group and four from the control group. The cure and marked response rate was 75.4%(43/57) in the observation group, which was significantly higher than that in the control group[57.1%(32/56),P<0.05]. The clinical recovery time, time to complete defervescence, and time to relief of cough and sputum in the observation group were all significantly shorter than those in the control group(P<0.05). The clinical recovery rate based on TCM syndrome scores was 47.3%(27/57) in the observation group, significantly higher than that in the control group[28.6%(16/56),P<0.05]. At the time of clinical recovery, fever resolved in 100% of patients in both groups; the disappearance rates of cough, laryngeal wheezing, and sticky, difficult?to?expectorate sputum were significantly higher in the observation group than in the control group(P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusion The "Qingxuan Tongluo" method for the treatment of macrolide?resistant Mycoplasma pneumoniae pneumonia in children can significantly shorten the time to defervescence, the time of cough relief, and clinical recovery time, and increase the cure and marked response rate, which demonstrates favorable clinical safety.

Key words: Macrolide-resistant Mycoplasma pneumoniae pneumonia(MRMPP), "Qingxuan Tongluo" method, Efficacy observation, Child